Transient ischemic attack (TIA)

A transient ischemic attack (TIA) is like a stroke, producing similar symptoms, but usually lasting only a few minutes and causing no permanent damage. Often called a ministroke, a transient ischemic attack may be a warning. About 1 in 3 people who have a transient ischemic attack will eventually have a stroke, with about half occurring within a year after the transient ischemic attack. A transient ischemic attack can serve as both a warning and an opportunity — a warning of an impending stroke and an opportunity to take steps to prevent it.

Risk Factors for a TIA

High blood pressure. Treat it. Eat a balanced diet, maintain a healthy weight, and exercise to reduce blood pressure. Drugs are also available.

Cigarette smoking. Quit. Medical help is available to help quit.

Heart disease. Manage it. Your doctor can treat your heart disease and may prescribe medication to help prevent the formation of clots.

Diabetes. Control it. Treatment can delay complications that increase the risk of TIA.

Symptoms of a transient ischemic attack (TIA)

The main symptoms of a TIA can be remembered with the word FAST:

Face – the face may have dropped on 1 side, the person may not be able to smile, or their mouth or eye may have dropped.

Arms – the person may not be able to lift both arms and keep them there because of weakness or numbness in 1 arm.

Speech – their speech may be slurred or garbled, or the person may not be able to talk at all, despite appearing to be awake; they may also have problems understanding what you're saying to them.

Time – it's time to dial 999 immediately if you see any of these signs or symptoms.

Those are the clearest red flags, but you may also notice:

• Balance and coordination problems
• Blindness or blurred vision in one or both eyes
• Can't move one whole side of your body
• Confusion and a hard time understanding others
• Dizziness
• Sudden, severe headache
• Trouble swallowing

Prevention

Knowing your risk factors and living healthfully are the best things you can do to prevent a TIA. Included in a healthy lifestyle are regular medical checkups. Also:

• Don't smoke. Stopping smoking reduces your risk of a TIA or a stroke.
• Limit cholesterol and fat. Cutting back on cholesterol and fat, especially saturated fat and trans fat, in your diet may reduce buildup of plaques in your arteries.
• Eat plenty of fruits and vegetables. These foods contain nutrients such as potassium, folate and antioxidants, which may protect against a TIA or a stroke.
• Limit sodium. If you have high blood pressure, avoiding salty foods and not adding salt to food may reduce your blood pressure. Avoiding salt may not prevent hypertension, but excess sodium may increase blood pressure in people who are sensitive to sodium.
• Exercise regularly. If you have high blood pressure, regular exercise is one of the few ways you can lower your blood pressure without drugs.
• Limit alcohol intake. Drink alcohol in moderation, if at all. The recommended limit is no more than one drink daily for women and two a day for men.
• Maintain a healthy weight. Being overweight contributes to other risk factors, such as high blood pressure, cardiovascular disease and diabetes. Losing weight with diet and exercise may lower your blood pressure and improve your cholesterol levels.
• Don't use illicit drugs. Drugs such as cocaine are associated with an increased risk of a TIA or a stroke.
• Control diabetes. You can manage diabetes and high blood pressure with diet, exercise, weight control and, when necessary, medication.

Treatment

Once your doctor has determined the cause of your transient ischemic attack, the goal of treatment is to correct the abnormality and prevent a stroke. Depending on the cause of your TIA, your doctor may prescribe medication to reduce the tendency for blood to clot or may recommend surgery or a balloon procedure (angioplasty).

Medications

Doctors use several medications to decrease the likelihood of a stroke after a transient ischemic attack. The medication selected depends on the location, cause, severity and type of TIA. Your doctor may prescribe:

Anti-platelet drugs. These medications make your platelets, one of the circulating blood cell types, less likely to stick together. When blood vessels are injured, sticky platelets begin to form clots, a process completed by clotting proteins in blood plasma.

Anticoagulants. These drugs include heparin and warfarin (Coumadin, Jantoven). They affect clotting-system proteins instead of platelet function. Heparin is used for a short time and warfarin over a longer term.

Thrombolytic agents. In certain cases, thrombolytic therapy is used to treat an ongoing stroke by dissolving blood clots that are blocking blood flow to the brain.

Surgery

• Carotid endarterectomy
• Angioplasty

Source:

1. https://www.stroke.org/en/about-stroke/types-of-stroke/tia-transient-ischemic-attack
2. https://www.mayoclinic.org/diseases-conditions/transient-ischemic-attack
3. https://www.nhs.uk/conditions/transient-ischaemic-attack-tia/